NPIMap

Organization Active NPI

Shoreline Dental PLLC

  • General Practice Dentistry
  • Norton Shores, MI
National Provider Identifier
1013211093
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901019459 Issued in MI
Legal business name
SHORELINE DENTAL PLLC
Practice address
1221 E Sherman Blvd
Norton Shores, MI 49444-1811
Phone
(231) 739-5105
Fax
(231) 739-7432
NPI assigned
Jan 5, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Elias J Achey, DMD
Title
Owner
Phone
(231) 739-5105

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2901019459 MI Primary

Addresses

Primary practice location

1221 E Sherman Blvd
Norton Shores, MI 49444-1811

Mailing address

1221 E Sherman Blvd
Norton Shores, MI 49444-1811
Phone (231) 739-5105

Other identifiers 1

IdentifierTypeStateIssuer
2901019459OtherMISTATE LICENSE

National Provider Directory

National Provider Directory

Locations

1221 E Sherman Blvd
Norton Shores, MI 49444
Phone (231) 638-4581

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1294185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405555200000",
    "number": "1013211093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 E SHERMAN BLVD",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494441811",
            "telephone_number": "231-739-5105",
            "fax_number": "231-739-7432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 E SHERMAN BLVD",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494441811",
            "telephone_number": "231-739-5105",
            "fax_number": "231-739-7432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORELINE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-05",
        "last_updated": "2014-07-17",
        "status": "A",
        "authorized_official_last_name": "ACHEY",
        "authorized_official_first_name": "ELIAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-739-5105",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901019459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2901019459",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norton Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.